Audit 365182

FY End
2024-12-31
Total Expended
$79.49M
Findings
2
Programs
49
Year: 2024 Accepted: 2025-08-28

Organization Exclusion Status:

Checking exclusion status...

Findings

ID Ref Severity Repeat Requirement
574976 2024-001 Significant Deficiency - I
1151418 2024-001 Significant Deficiency - I

Programs

ALN Program Spent Major Findings
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $19.93M - 0
93.395 Cancer Biology Research $3.88M Yes 0
93.393 Cancer Cause and Prevention Research $1.37M Yes 0
12.RD W911sr2490002 $1.08M Yes 0
93.121 Oral Diseases and Disorders Research $825,113 Yes 0
93.859 Biomedical Research and Research Training $693,970 Yes 0
93.226 Research on Healthcare Costs, Quality and Outcomes $561,943 Yes 0
93.RD Hhsn272201700040i/ 75n93022f00006 $538,227 Yes 0
93.353 21st Century Cures Act - Beau Biden Cancer Moonshot $529,523 Yes 0
93.242 Mental Health Research Grants $381,350 Yes 0
43.001 Science $367,691 Yes 0
93.RD 75n91019d00020/ 75n91021f00003 $337,124 Yes 0
93.384 Advanced Research Projects Agency for Health (arpa-H) $335,185 Yes 0
93.RD 75n91019d00020/ 75n91022f00004 $328,291 Yes 0
93.866 Aging Research $326,087 Yes 0
93.RD 75n91019d00021/ 75n91023f00002 $289,357 Yes 0
93.839 Blood Diseases and Resources Research $261,429 Yes 0
12.351 Scientific Research - Combating Weapons of Mass Destruction $195,703 Yes 0
93.846 Arthritis, Musculoskeletal and Skin Diseases Research $172,284 Yes 0
93.083 Prevention of Disease, Disability, and Death Through Immunization and Control of Respiratory and Related Diseases $135,261 Yes 0
93.273 Alcohol Research Programs $131,318 Yes 0
93.RD 75a50123c00020 $125,221 Yes 0
93.RD 75n93019c00045 $121,167 Yes 0
47.070 Computer and Information Science and Engineering $87,061 Yes 0
93.310 Trans-Nih Research Support $84,532 Yes 0
93.RD 7200aa22ca00002 $78,800 Yes 0
93.398 Cancer Research Manpower $77,353 Yes 0
93.395 Cancer Treatment Research $72,634 Yes 0
93.350 National Center for Advancing Translational Sciences $69,807 Yes 0
93.RD 75n91019d00020/ 75n91020f00001 $59,008 Yes 0
93.838 Lung Diseases Research $54,004 Yes 0
93.847 Diabetes, Digestive, and Kidney Diseases Extramural Research $43,901 Yes 0
93.855 Allergy and Infectious Diseases Research $39,319 Yes 0
93.RD 75n91024d00005/ 75n91024f00002 $35,222 Yes 0
12.420 Military Medical Research and Development $32,352 Yes 0
93.879 Medical Library Assistance $32,068 Yes 0
93.394 Cancer Detection and Diagnosis Research $24,421 Yes 0
93.867 Vision Research $22,130 Yes 0
93.989 International Research and Research Training $18,943 Yes 0
93.286 Discovery and Applied Research for Technological Innovations to Improve Human Health $15,021 Yes 0
93.837 Cardiovascular Diseases Research $10,607 Yes 0
93.361 Nursing Research $8,790 Yes 0
93.396 Cancer Biology Research $8,183 Yes 0
93.397 Cancer Centers Support Grants $7,827 Yes 0
93.433 Acl National Institute on Disability, Independent Living, and Rehabilitation Research $5,775 Yes 0
93.853 Extramural Research Programs in the Neurosciences and Neurological Disorders $3,679 Yes 0
93.113 Environmental Health $3,082 Yes 0
47.041 Engineering $2,295 Yes 0
47.049 Computer and Information Science and Engineering $2,254 Yes 0

Contacts

Name Title Type
XJUCJAYJWYV1 Israel Ramirez JR Auditee
3465617936 Debra Kohnle Auditor
No contacts on file

Notes to SEFA

Title: 1. Basis of Presentation Accounting Policies: The accompanying Schedule of Expenditures of Federal and State Awards (SEFA) includes the federal and state grant activity of Houston Methodist (“Methodist”) and is presented on the modified cash basis of accounting (see Note 3).The information in the SEFA is presented in accordance with the requirements of Title 2 US Code of Federal Regulations (“CFR”) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (“Uniform Guidance”), or the Texas Grant Management Standards (“TxGMS”). De Minimis Rate Used: N Rate Explanation: Methodist has negotiated an indirect cost rate with the federal government and, therefore, has not elected to use the 10% de minimis cost rate as covered in Uniform Guidance at 2 CFR 200.414, Indirect (F&A) costs. The accompanying Schedule of Expenditures of Federal and State Awards (SEFA) includes the federal and state grant activity of Houston Methodist (“Methodist”) and is presented on the modified cash basis of accounting (see Note 3).The information in the SEFA is presented in accordance with the requirements of Title 2 US Code of Federal Regulations (“CFR”) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (“Uniform Guidance”), or the Texas Grant Management Standards (“TxGMS”).
Title: 2. De Minimis Cost Rate Accounting Policies: The accompanying Schedule of Expenditures of Federal and State Awards (SEFA) includes the federal and state grant activity of Houston Methodist (“Methodist”) and is presented on the modified cash basis of accounting (see Note 3).The information in the SEFA is presented in accordance with the requirements of Title 2 US Code of Federal Regulations (“CFR”) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (“Uniform Guidance”), or the Texas Grant Management Standards (“TxGMS”). De Minimis Rate Used: N Rate Explanation: Methodist has negotiated an indirect cost rate with the federal government and, therefore, has not elected to use the 10% de minimis cost rate as covered in Uniform Guidance at 2 CFR 200.414, Indirect (F&A) costs. Methodist has negotiated an indirect cost rate with the federal government and, therefore, has not elected to use the 10% de minimis cost rate as covered in Uniform Guidance at 2 CFR 200.414, Indirect (F&A) costs.
Title: Disaster Grants – Public Assistance (Presidentially Declared Disasters) Accounting Policies: The accompanying Schedule of Expenditures of Federal and State Awards (SEFA) includes the federal and state grant activity of Houston Methodist (“Methodist”) and is presented on the modified cash basis of accounting (see Note 3).The information in the SEFA is presented in accordance with the requirements of Title 2 US Code of Federal Regulations (“CFR”) Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (“Uniform Guidance”), or the Texas Grant Management Standards (“TxGMS”). De Minimis Rate Used: N Rate Explanation: Methodist has negotiated an indirect cost rate with the federal government and, therefore, has not elected to use the 10% de minimis cost rate as covered in Uniform Guidance at 2 CFR 200.414, Indirect (F&A) costs. In accordance with the guidance from the U.S Department of Homeland Security, the amount presented on the SEFA for Assistance Listing Number 97.036 – COVID – 19 Disaster Grants- Public Assistance (Presidentially Declared Disasters), represents expenditures that were incurred and approved by the Federal Emergency Management Agency (FEMA) for the year ended December 31, 2024. Houston Methodist reported $19,928,025 in COVID-19 related funding from FEMA for the year ended December 31, 2024 on the SEFA.

Finding Details

Criteria or Specific Requirement (Including Statutory, Regulatory or Other Citation): 2 CFR 200.303 requires that the non-Federal entity must “(a) establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States and the “Internal Control Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).” 2 CFR 200.318 (i) General Procurement Standards states, “the non-Federal entity must maintain records sufficient to detail the history of procurement. These records will include, but are not necessarily limited to, the following: Rationale for the method of procurement, selection of contract type, contractor selection or rejection, and the basis for the contract price.” Condition: Methodist did not maintain records for procurements sufficient to detail the history of procurement, including the rationale for the method of procurement, selection of contract type, contractor selection or rejection, and the basis for the contract price. Cause: Methodist did not have effective internal controls and procedures in place to ensure Methodist maintained records for procurements sufficient to detail the history of procurement, including the rationale for the method of procurement and other required elements. Effect or Potential Effect: Methodist did not comply with the general procurement standards and methods of procurement to be followed per the Uniform Guidance to maintain sufficient detail of the history of the procurement, including the rationale of the method of procurement. Questioned Costs: $12,807 Context: EY selected and tested 10 procurements over $10,000 with expenditures totaling $182,415 from a population of $1,289,446 procurements over $10,000 during the year ended December 31, 2024. Of the 10 expenditures selected for testing 1 procurement totaling $12,807 did not have evidence of sole source justification Identification as a Repeat Finding: This is not a repeat finding. Recommendation: Methodist should retain written documentation for procurements, documenting the history of the procurement prior to the procurement of goods or services including, but not limited to, the rationale for the method of procurement, selection of contract type, contractor selection or rejection, and the basis for the contract price. Views of Responsible Officials: Methodist recognizes the current gap between Supply Chain Services and the Research Institute related to retaining documents for procurement activities. Supply Chain Services will develop processes to retain written documentation for procurement activities in accordance with regulatory standards. As Methodist is in transition to a new ERP system in Quarter 1, 2026, Supply Chain Services will include strategies to address the needs in both the short term and long term.
Criteria or Specific Requirement (Including Statutory, Regulatory or Other Citation): 2 CFR 200.303 requires that the non-Federal entity must “(a) establish and maintain effective internal control over the Federal award that provides reasonable assurance that the non-Federal entity is managing the Federal award in compliance with Federal statutes, regulations and the terms and conditions of the Federal award. These internal controls should be in compliance with guidance in “Standards for Internal Control in the Federal Government” issued by the Comptroller General of the United States and the “Internal Control Integrated Framework”, issued by the Committee of Sponsoring Organizations of the Treadway Commission (COSO).” 2 CFR 200.318 (i) General Procurement Standards states, “the non-Federal entity must maintain records sufficient to detail the history of procurement. These records will include, but are not necessarily limited to, the following: Rationale for the method of procurement, selection of contract type, contractor selection or rejection, and the basis for the contract price.” Condition: Methodist did not maintain records for procurements sufficient to detail the history of procurement, including the rationale for the method of procurement, selection of contract type, contractor selection or rejection, and the basis for the contract price. Cause: Methodist did not have effective internal controls and procedures in place to ensure Methodist maintained records for procurements sufficient to detail the history of procurement, including the rationale for the method of procurement and other required elements. Effect or Potential Effect: Methodist did not comply with the general procurement standards and methods of procurement to be followed per the Uniform Guidance to maintain sufficient detail of the history of the procurement, including the rationale of the method of procurement. Questioned Costs: $12,807 Context: EY selected and tested 10 procurements over $10,000 with expenditures totaling $182,415 from a population of $1,289,446 procurements over $10,000 during the year ended December 31, 2024. Of the 10 expenditures selected for testing 1 procurement totaling $12,807 did not have evidence of sole source justification Identification as a Repeat Finding: This is not a repeat finding. Recommendation: Methodist should retain written documentation for procurements, documenting the history of the procurement prior to the procurement of goods or services including, but not limited to, the rationale for the method of procurement, selection of contract type, contractor selection or rejection, and the basis for the contract price. Views of Responsible Officials: Methodist recognizes the current gap between Supply Chain Services and the Research Institute related to retaining documents for procurement activities. Supply Chain Services will develop processes to retain written documentation for procurement activities in accordance with regulatory standards. As Methodist is in transition to a new ERP system in Quarter 1, 2026, Supply Chain Services will include strategies to address the needs in both the short term and long term.